January - December 2019 Business & Occupation Activities ...

[Pages:4]January - December 2019 A 19

Mail to: State of Washington Department of Revenue PO Box 47464 Olympia, WA 98504-7464

4 Use Black Ink & Return Original Form.

4 Only fill in the classifications you qualify for.

Business & Occupation Activities Return

If you had no business activity, check the box and mail this return (unless filed electronically)

Name Business Name Street Address City, State, Zip

Account ID

Mailing Address Change?

Business Closed?

4 Use Black Ink & Return Original Form.

Date Closed ___/___/___ See Additional Information, pg 2 Other Correspondence?

I. State Business and Occupation (B&O) Tax

1. Intl Charter Freight Brokers; Stevedoring; Assisted Living Facilities [28]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .00275

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2. Travel Agent/Tour Operator ($250,000 or less) [27]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .00275

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3. Travel Agent/Tour Operator (over $250,000) [250] (July 1 - Dec 31 ONLY)

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

.

X .009

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4. Insurance Producers; Title Insurance Agents; Surplus Line Broker Commissions; Child Care [14]

Gross Amount

,,

Deductions*

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Taxable Amount

.= , ,

Rate Tax Due

.

X .00484

,

.

5. Royalties [80]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .015

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6. Wholesaling [03]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .00484

,.

7. For Profit Hospitals; Scientific R&D [135]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .015

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8. Service & Other Activities [04]

Gross Amount

Deductions*

Taxable Amount

Rate Tax Due

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,

,

.

X .015

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* Deductions taken but not itemized on pages 3 & 4 will be disallowed. DUE DATE: April 15, 2020

State and Local Use Tax/Deferred Sales Tax (See page 2.)4

IV. Totals

* 9% Penalty Assessed After April 15, 2020 19% Penalty Assessed After June 01, 2020

19. Total Tax Due from Section I (Tax due from lines 1-8)

,,.

29% Penalty Assessed After June 30, 2020 If the due date falls on a weekend or legal holiday, the due date is extended to the next business day.

Filing an Amended Return? Check this box and attach amended return

20. Total Tax Due from Section II (Tax due from line 14)

,

,

.

21. Total All Addendums (Example: Local Sales/Use Tax)

,

,

.

and letter of explanation. Penalty waiver request? Check this box and attach a letter of explanation.

22. Subtotal (add lines 19-21)

,,.

4 Make check or money order payable to the Washington State Department of Revenue.

23. Total Credit from Section III (from page 2, line 18)

,,.

4 Please write your Account ID on your check.

24. Subtotal (subtract line 23 from line 22)

,,.

4 Signature

4 Print Name

4 Phone Number (

)

Date / /

25. Interest

26. * Add Penalty, if Applicable

(Minimum $5.00)

%

27. Total Amount Due

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Page 1

II. State and Local Use Tax

State Use Tax/Deferred Sales Tax [05] (Also complete Local Use Tax/Deferred Sales Tax below.)

Gross Amount **

9.

, ,.

** Value of articles used or consumed

Rate

Tax Due

on which no Washington sales tax has been paid.

X .065 =

,.

Local Use Tax/Deferred Sales Tax [46]

(Note: If more than two locations, please report all information on the Local Sales and Use Tax Addendum. If you need an addendum, go to our website at dor..)

Location Code

10.

Value of Articles

,,.

Location Code

11.

Value of Articles

,,.

Value of Articles ***

12. Total Value of Articles

,,.

Local Rate

X.

=

Enter applicable tax rate

Local Rate

X.

=

Enter applicable tax rate

Tax Due City or County

,.

Tax Due City or County

,.

*** This amount must be the same as State Use Tax/ Deferred Sales Tax Gross Amount, line 7.

Taxable Amount

13. Litter Tax [36]

,,.

Rate

Tax Due

X

.00015

=

,.

Additional Information

The easiest way to file your return is to use our free electronic filing service at dor..

Tax Due

14. Total Tax Due from Section II (Transfer total to page 1, line 20.)

,

,

.

III. Credits

Penalties and Interest

Amount of Credit

Penalties: ? Any unpaid tax (including partial payments) is

15. Small Business B&O Tax Credit

[815]

,,.

subject to delinquent return penalty at the rate on

Amount of Credit

the front of the return. (RCW 82.32.090) ? A 5% assessment penalty may be assessed if the

16. International Services [855] Credit

,,.

return is substantially underpaid. (RCW 82.32.090)

Amount of Credit

Interest: Interest will accrue from the 1st day of the month following the due date of the return is paid in

17. Other Credits (Attach appropriate documents.)

[810]

,,.

full.

Telephone Assistance ? If you did not have business activity call

Amount of Credit

18. Total Credit (Transfer total to page 1, line 23.)

,,.

360-705-6705. At the greeting, follow the

instructions given to file a no business activity

return. Do not mail a paper return back to the

Department.

For tax assistance or to request this document in an alternate format, please call 360-705-6705. Teletype (TTY) users may use the Washington Relay Service by calling 711.

Internet/Fax

(11-12-19)

Page 2

MAIL TO: Washington State Department of Revenue PO Box 47464 Olympia WA 98504-7464

Jan - Dec 2019 Business & Occupation Activities

Deduction Detail

A 19

? If you have deductions, return this page. If you do not have deductions, do not return this page. ? We cannot approve deductions taken on the Business & Occupation Activities Return that are not itemized on this page. ? Report deductions under the heading that corresponds to your reporting activity. ? Transfer the total deduction amount for each classification from this page to the corresponding line on page 1 of your tax return.

If completing, fill out name, Account ID and attach to your Business & Occupation Activities Return.

Name

1. Intl Charter Freight Brokers; Stevedoring; Assisted Living Facilities

I.D.

Amount

Bad Debts

[2801]

, ,.

Cash & Trade Discounts [2802]

, ,.

Other (Explain below): [2899]

, ,.

Total

, ,.

2. Travel Agent/Tour Operator ($250,000 or less)

Bad Debts

I.D.

[2701]

Amount

,

Cash & Trade Discounts

[2702]

,

Other (Explain below): [2799]

,

,. ,. ,.

Total

, ,.

3. Travel Agent/Tour Operator (over $250,000) (July 1 - Dec 31 ONLY)

I.D.

Amount

Bad Debts

[25001]

, ,.

Cash & Trade Discounts

[25002]

, ,.

Other (Explain below): [25099]

, ,.

Total

, ,.

4. Insurance Producers; Title Insurance Agents; Surplus Line Broker Commissions; Child Care

I.D.

Amount

Bad Debts

[1401]

, ,.

Other (Explain below): [1499]

, ,.

Total

, ,.

Account ID

5. Royalties Bad Debts

I.D.

[8001]

Amount

,

Cash & Trade Discounts [8002]

,

Advances Reimbursements; Rtns & Allowances

[8007]

,

Other (Explain below): [8099]

,

Total

,

6 Wholesaling

Bad Debts

I.D.

[0301]

Amount

,

Cash & Trade Discounts [0302]

,

Interstate & Foreign Sales [0304]

,

Motor Vehicle Fuel Tax [0305]

,

Casual Sales; Accommodation Sales

[0306]

,

Advances Reimbursements; Rtns & Allowances

[0307]

,

No Local Activity

[0308]

,

Dairy, Fruit/Veg, & Seafood Mfd Products (see below)*

[0367]

,

Dairy Products Used in Mfg of Dairy Products

[0375]

,

Other (Explain below): [0399]

,

Total

,

*Local sales for transport out-of-state

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Internet/Fax

(11-12-19)

Page 3

7. For Profit Hospitals; Scientific R&D

Bad Debts

I.D.

[13501]

Cash & Trade Discounts [13502]

Amount

, ,

Apportionment (Interstate [13504] & Foreign Sales)

,

Advances Reimburse- [13507] ments; Rtns & Allowances

,

Qualified Initiation Fees; [13511] Dues; Contributions Rec'd

,

Other (Explain below): [13599]

,

Total

,

8. Service & Other Activities

Bad Debts

I.D.

[0401]

Amount

,

Cash & Trade Discounts [0402]

,

Apportionment (Interstate & Foreign Sales)

[0404]

,

Advances Reimbursements; Rtns & Allowances

[0407]

,

Gambling Prizes & Cash Pay-Outs

[0410]

,

Qualified Initiation Fees; Dues; Contributions Rec'd

[0411]

,

Interest on Certain Invest/Loan Obligations

[0412]

,

Artistic/Cultural Activities [0416]

,

Other (Explain below): [0499]

,

Total

,

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.

4 If you have deductions, please include this Deduction Detail page with your return.

For tax assistance or to request this document in an alternate format, please call 360-705-6705. Teletype (TTY) users may use the Washington Relay Service by calling 711.

402404041013A19

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